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Ann Thorac Surg 2004;78:360-368
© 2004 The Society of Thoracic Surgeons

Review

Hypoxic pulmonary vasoconstriction in cardiothoracic surgery: basic mechanisms to potential therapies

Ben M. Tsai, MDa, Meijing Wang, MDa,c, Mark W. Turrentine, MDa, Yousuf Mahomed, MDa, John W. Brown, MDa, Daniel R. Meldrum, MDa,b,c*

a Section of Cardiothoracic Surgery, Department of Surgery, Indianapolis, Indiana, USA
b Department of Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
c Indiana Center for Vascular Biology and Medicine, Indianapolis, Indiana, USA

* Address reprint requests to Dr Meldrum, 545 Barnhill Dr, Emerson Hall 215, Indianapolis, IN, USA 46202
e-mail: dmeldrum{at}iupui.edu

Hypoxic pulmonary vasoconstriction is postulated to be an adaptive mechanism to match lung perfusion with ventilation; however, the consequences of the maladaptive effects of pulmonary vasoconstriction represent formidable therapeutic challenges. Understanding the basic mechanisms of hypoxic pulmonary vasoconstriction will enhance the assimilation of translational research into clinical practice. The purposes of this review are to (1) define basic mechanisms of pulmonary vasoconstriction and vasorelaxation; (2) delineate the biphasic contractile response to hypoxia; (3) critically examine data that support the mediator hypothesis versus the ion channel hypothesis; and (4) explore potential mechanistic-based therapies for hypoxic pulmonary vasoconstriction.




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